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Full 2025/2026 FITZ Exit Exam
Comprehensive Testbank Section A: Family
Nurse Practitioner (FNP) – 100 .uestions
Section B: Adult-Gerontology Primary Care NP
(AGPCNP) – 100 .uestions Section C: Acute
Care NP (ACNP) – 100 .uestions Section D:
Psych
Question 1 (FNP)
A 45-year-old female presents with fatigue, weight gain,
constipation, and cold intolerance for 3 months. Exam shows
bradycardia, dry skin, and delayed deep tendon reflexes. TSH
is 12.5 mIU/L (normal 0.4-4.0). What is the most appropriate
next step?
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A) Levothyroxine 1.6 mcg/kg/day
B) Levothyroxine 25 mcg daily with recheck in 6 weeks
C) Triiodothyronine (T3) 25 mcg daily
D) Observe and recheck TSH in 3 months
Correct Answer: B
Rationale: For mild hypothyroidism in a younger adult without
cardiac disease, start low-dose levothyroxine (25-50 mcg) and
titrate every 4-6 weeks. Option A is full replacement (too
aggressive initially). T3 is not first-line. Observation is
inappropriate given symptoms.
Question 2 (FNP)
A 6-year-old boy presents with 2 days of fever (101.5°F),
mucopurulent nasal discharge, and facial pain. Symptoms worsen
after initial improvement. Exam reveals maxillary tooth
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tenderness and poor transillumination. What is the most
appropriate management?
A) Amoxicillin 45 mg/kg BID for 10 days
B) Amoxicillin-clavulanate 45 mg/kg BID for 14 days
C) Nasal saline irrigation and intranasal corticosteroids
D) Observation for 7 more days
Correct Answer: A
Rationale: This is acute bacterial rhinosinusitis (double-sickening,
purulent discharge, facial pain). First-line is amoxicillin 45 mg/kg
BID × 10 days. Amoxicillin-clavulanate reserved for treatment
failure or daycare attendance. Observation appropriate only if
mild symptoms <10 days.
Question 3 (FNP)
A 58-year-old male with HTN and DM2 has BP 148/92 on
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lisinopril 20 mg daily. Home readings average 145/90. Labs:
K+ 4.2, Cr 0.9. What is the best next step?
A) Add hydrochlorothiazide 12.5 mg daily
B) Increase lisinopril to 40 mg daily
C) Add amlodipine 5 mg daily
D) Refer to nephrology
Correct Answer: C
Rationale: Per 2023-2024 hypertension guidelines (ACC/AHA),
add CCB (amlodipine) as second agent when ACEi/ARB alone
insufficient. Thiazide is third-line in non-Black patients without
edema. Doubling lisinopril has diminishing returns.
Question 4 (FNP) - Scenario
A 32-year-old G2P1 at 28 weeks gestation reports headache,
blurred vision, and right upper quadrant pain. BP 168/104.
Urine dipstick: 3+ protein. Which medication is contraindicated?
Full 2025/2026 FITZ Exit Exam
Comprehensive Testbank Section A: Family
Nurse Practitioner (FNP) – 100 .uestions
Section B: Adult-Gerontology Primary Care NP
(AGPCNP) – 100 .uestions Section C: Acute
Care NP (ACNP) – 100 .uestions Section D:
Psych
Question 1 (FNP)
A 45-year-old female presents with fatigue, weight gain,
constipation, and cold intolerance for 3 months. Exam shows
bradycardia, dry skin, and delayed deep tendon reflexes. TSH
is 12.5 mIU/L (normal 0.4-4.0). What is the most appropriate
next step?
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A) Levothyroxine 1.6 mcg/kg/day
B) Levothyroxine 25 mcg daily with recheck in 6 weeks
C) Triiodothyronine (T3) 25 mcg daily
D) Observe and recheck TSH in 3 months
Correct Answer: B
Rationale: For mild hypothyroidism in a younger adult without
cardiac disease, start low-dose levothyroxine (25-50 mcg) and
titrate every 4-6 weeks. Option A is full replacement (too
aggressive initially). T3 is not first-line. Observation is
inappropriate given symptoms.
Question 2 (FNP)
A 6-year-old boy presents with 2 days of fever (101.5°F),
mucopurulent nasal discharge, and facial pain. Symptoms worsen
after initial improvement. Exam reveals maxillary tooth
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tenderness and poor transillumination. What is the most
appropriate management?
A) Amoxicillin 45 mg/kg BID for 10 days
B) Amoxicillin-clavulanate 45 mg/kg BID for 14 days
C) Nasal saline irrigation and intranasal corticosteroids
D) Observation for 7 more days
Correct Answer: A
Rationale: This is acute bacterial rhinosinusitis (double-sickening,
purulent discharge, facial pain). First-line is amoxicillin 45 mg/kg
BID × 10 days. Amoxicillin-clavulanate reserved for treatment
failure or daycare attendance. Observation appropriate only if
mild symptoms <10 days.
Question 3 (FNP)
A 58-year-old male with HTN and DM2 has BP 148/92 on
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lisinopril 20 mg daily. Home readings average 145/90. Labs:
K+ 4.2, Cr 0.9. What is the best next step?
A) Add hydrochlorothiazide 12.5 mg daily
B) Increase lisinopril to 40 mg daily
C) Add amlodipine 5 mg daily
D) Refer to nephrology
Correct Answer: C
Rationale: Per 2023-2024 hypertension guidelines (ACC/AHA),
add CCB (amlodipine) as second agent when ACEi/ARB alone
insufficient. Thiazide is third-line in non-Black patients without
edema. Doubling lisinopril has diminishing returns.
Question 4 (FNP) - Scenario
A 32-year-old G2P1 at 28 weeks gestation reports headache,
blurred vision, and right upper quadrant pain. BP 168/104.
Urine dipstick: 3+ protein. Which medication is contraindicated?
